Stark II law

Stark II law

Stark II is a law that prohibits doctors and other medical providers from referring to certain health care services to organizations that have a financial relationship with the physician or a relative unless an exception applies. These services are commonly referred to as designated health services (DHS).

Anti-Kickback Statute

The Anti-Kickback Statute refers to federal criminal law. The law makes knowingly and willfully exchange of payment or other valuable resources in order to influence referrals of health care services and other programs related to the patient illegal (Hawkins, 2018).

False Claims Act

This is the most critical tool in the United States. The act allows taxpayers in the nation to recover stolen money from the government’s fraud contractors.

The Importance of Stark II to Healthcare Providers

According to Olavarria (2016), one’s Stark II is violated; it does not matter if the violation corrupted clinical judgment, impend the patient choice, or affected the referral patterns. Regardless of whether the decision was made willingly or not, the violation must be compensated by a medical refund. As such, the law discourages referrals for financial compensation. As a result, providers base their medical decision on quality rather than financial compensation. Therefore, a referral should never be established where the provider or their family members have a financial stake.

The Importance of the Anti-Kickback Statute to Healthcare Providers

The law prohibits the receipt of any paying, soliciting, offering, or receiving of favor. Such favors may include money or anything valuable to induce referrals from anyone. Bribes, kickbacks, rebates, purchases, or leases are examples of favors (Hawkins, 2018). Notably, these favors may be directly or indirectly given to managers, physicians, or employees within the healthcare organization. The law prohibits such favors that affect federal healthcare programs.

The Importance of the False Claims Act to Healthcare Providers

The mechanics of the law weeds out and discourage frivolous lawsuits and meritless claims. It creates awareness for workers in any organization that they risk losing their jobs once involved with fraud. On the other hand, it ensures that companies meet the government and people’s expectations. Once a company fraud, the law allows taxpayers to recover stolen money from the government’s fraud contractors.

Analyze the Factors That Influence Healthcare Pricing In Healthcare Organizations

Pricing is an integral part of any organization’s operations. Several factors influence pricing in a healthcare organization. In the United States, these factors include population, the intensity of services, aging population, demand for health services, and disease prevalence. An increase in population leads to an increase in pricing as the need for health services grows.

The Relationship between Financial Planning and Strategic Planning

Financial planning and strategic planning are commonly intertwined in a business. They often work together cyclically. The current strategy of an organization is affected by any change in budget and vice versa. For example, before changing a strategy, an individual must confirm if they have enough money to execute it.

How a Financial Plan Is Developed

The process of developing a financial plan comprises of six-step procedures. First, an individual must determine his or her current financial situation. Secondly, they should develop financial goals. Third, identify alternatives. Fourth, evaluate each of the identified alternatives. Fifth, the individual should create and implement an action plan. Finally, he or she should revise the plan.

How a HIM Manager Should Interact With the Finance Department to Ensure The

Efficacy of a Financial Plan

Health information manager (HIM) ensures that the patients’ medical data is protected. On the other hand, the financial department deals with all monetary issues within the healthcare organization (Steiss, & Nwagwu, 2019). Based on the critical roles played by both HIM and the financial department in the organization, how they interact is vital affects the efficacy of a financial plan. Consequently, HIM must portray qualities such as integrity, transparency, and trustworthiness.

The Financial Management Control Process, Including Budgeting and Financial

Planning

The financial management control process refers to controlling and directing the financial effects of the user’s budget operations. It enables users to achieve their objectives. On the other hand, budgeting focuses on an individual’s immediate money issues (Steiss & Nwagwu, 2019). The individual considers the amount he or she earns before estimating the amount it will cost to maintain their current lifestyle. After determining the amount, the individual decides on a plan. Financial planning helps an individual to consider what he or she can be with their money.